Pelvic floor muscle therapy (PFMT) “could be included in first‐line conservative management programs” for women with urinary incontinence (UI), according to the authors of a recently updated Cochrane systematic review. While the conclusion itself isn’t new, the revision includes more evidence that makes the case for PFMT even stronger.

Authors analyzed data from 31 trials including a total of 1,817 women. The studies examined whether women were “cured” or “cured or improved” as a result of treatment for stress urinary incontinence (SUI), urgency urinary incontinence (UUI), or mixed urinary incontinence (MUI). Researchers also looked at the effects of PFMT on quality of life.

T-Score is a representation of how a patient’s bone mass density compares to an average 30 year old male. Patients are considered to have osteoporosis when their T-Score drops below -2.5 (25% less dense than average)

According to a 2013 study in the International Urogynecology Journal, women with osteopenia are at an increased risk of fecal incontinence. Researchers conducted a survey of 1,655 postmenopausal women who had undergone an osteoporosis evaluation. Of the respondents, 362 were diagnosed to have osteoporosis (T-score less than -2.5), 870 had osteopenia (T-score between -1 and -2.5), and a control of 423 women had a normal bone mass density.

The authors’ goal was to see which common pelvic floor conditions are associated with a loss in bone mass density. The survey found that “[o]verall prevalence of any urinary incontinence (UI) was 1,226/1,640 (75 %), with UI ≥2–3 times/week in 699/1,197 (58 %), fecal incontinence over the past month in 247/1,549 (16 %), and prolapse in 162/1,582 (10 %).”

A multivariate analysis showed that the women with osteopenia had increased risk of fecal incontinence compared to the other two groups. Women with osteoporosis were found to be at higher risk of urinary incontinence.

Bone density issues can complicate every part of a patient’s life, and pelvic health practitioners will benefit by understanding conditions like osteoporosis. The Meeks Method for Osteoporosiscourse offers clinicians a new set of tools to evaluate and treat osteoporotic patients. Join instructor Deb Gulbrandson, PT, DPT this September 22-23, 2018 in Detriot, or instructor Frank J Ciuba DPT, MS in Fairfield, CT on October 12-13, 2018 to expand your osteoporosis treatment skill set.

Susan Sills, a Brooklyn artist who until recently made life-size cutouts on plywood using a power saw, long suspected she might be at risk for developing Parkinson’s disease. Both her mother and grandfather had this neurological movement disorder, and she knew that it sometimes runs in families.

So she was not surprised when at age 72 she first noticed hand tremors and a neurologist confirmed that she had the disease. But to watch her in action three years later, it would be hard for a layperson to tell. She stands straight, walks briskly, speaks in clarion tones and maintains a schedule that could tire someone half her age.

Having wisely put the power saw aside, Ms. Sills now makes intricately designed art jewelry. She is also a docent at the Brooklyn Museum, participates in a cooperative art gallery and assists her husband’s business by entertaining customers.

Ms. Sills attributes her energy and well-being partly to the medication she takes but primarily to the hours she spends working out with a physical therapist and personal trainer, who have helped her develop an exercise regimen that, while not a cure, can alleviate Parkinson’s symptoms and slow progression of the disease.

“The exercises opened me up,” said Ms. Sills, allowing such symptoms as small steps, slow movements and tiny, cramped handwriting to subside.

“The earlier people begin exercising after a Parkinson’s diagnosis, and the higher the intensity of exercise they achieve, the better they are,” Marilyn Moffat, a physical therapist on the faculty of New York University, said. “Many different activities have been shown to be beneficial, including cycling, boxing, dancing and walking forward and backward on a treadmill. If someone doesn’t like one activity, there are others that can have equally good results.”

Unfortunately, Dr. Moffat added, “no one tells people with Parkinson’s what they could and should be doing unless they get to a physical therapist.” The typical delay in starting an effective exercise program also stems from the ability of medication to alleviate early symptoms, leaving patients with little incentive to exercise.

While everyone can benefit from exercise, it is especially important for people with a progressive movement disorder like Parkinson’s that can result in weakness, stiffness, difficulty walking, poor balance and falls, as well as impaired cognitive processing. Regular exercise bestows increased levels of fitness; a greater sense of well-being; stronger muscles and bones; healthier joints; more efficient breathing; and better digestion and blood circulation. The result is enhanced physical, mental and cognitive health, all of which are especially important to people with a chronic ailment.

For Parkinson’s patients in particular, regular exercise tailored to their needs can result in better posture; less stiffness; improved flexibility of muscles and joints; faster and safer walking ability; less difficulty performing the tasks of daily living; and an overall higher quality of life.

Patients who participate in exercise programs designed to mitigate symptoms and perhaps delay progression of Parkinson’s “can function independently at a higher level, have stronger feelings of well-being, and are happier about their quality of life,” said Dr. Moffat, who has witnessed major improvements in people she’s worked with.

Among the many exercise options is an agility program that incorporates the principles of tai chi, kayaking, boxing, lunges and Pilates. It was developed and proved safe and effective by Laurie A. King and Fay B. Horak at Oregon Health and Sciences University. The agility course includes navigating turns, doorways, hallways and small areas; tasks like walking with knees high and hands touching them; skipping; and shuffling from side to side.

In a report on their work in Physical Therapy, the journal of the American Physical Therapy Association, Dr. King and Dr. Horak explained that intense exercise can improve “plasticity” of the brain, protect against nervous system degeneration, and even reverse motor deficits.

Another program, called Rock Steady Boxing, was founded by Scott C. Newman, a former prosecutor in Marion County, Ind., who developed Parkinson’s at age 40. He reported significant improvements in his physical health, agility, daily functioning and quality of life shortly after he began high-energy workouts doing boxing moves a few years after his diagnosis.

Mr. Newman has pointed out that Parkinson’s is not a muscle wasting disease. Rather, the brain forgets how to tell the muscles what to do. He believed it should be possible to teach the brain to get muscles to work more effectively, which is what Rock Steady Boxing and other exercise programs for Parkinson’s disease seem to have achieved.

While it is best to begin a challenging exercise program early in the disease, Dr. Moffat and Mr. Newman say it can help at any stage. Rock Steady Boxing, for example, has created training programs suited to fitness levels at all stages of Parkinson’s.

Another personal experience, by a cross-country cyclist, resulted in a tandem cycling program for Parkinson’s patients. In a 200-mile trip across Iowa in 2003, Jay Alberts, a biomedical engineer at the Cleveland Clinic, pedaled in the lead position with a woman who has Parkinson’s. The pace he set forced her to pedal a third faster than she would have done on her own. The woman’s tremors disappeared while she was pedaling with Dr. Alberts, and he later showed in a controlled study that the ability of forced pedaling to suppress Parkinson’s symptoms can persist for weeks afterward.

Dr. Alberts suspects that the high-intensity exercise changes how the brain processes movement, resulting in improved motor function over all. The benefits of tandem cycling can be achieved indoors and out, even without a biking partner.
The exercise program that has mainly helped Ms. Sills, called L.S.V.T. BIG, evolved from the Lee Silverman Voice Treatment program – L.S.V.T. LOUD — created to improve the speech of Parkinson’s patients, who tend to talk more and more softly. Developed specifically to counter the unique movement impairments associated with Parkinson’s, it trains patients to “make big strong movements, not little weak ones,” Ms. Sills said, for example, taking big steps and swinging your arms widely when you walk. “This is the normal way to walk, but not when you have Parkinson’s, but it no longer feels strange to me,” she said.

Other programs tailored to benefit Parkinson’s patients include ParkFit, which fosters a more active lifestyle; Dance for PD, which has classes in every New York City borough and many other countries; and Microsoft Kinect Adventures, which uses Xbox games geared to different stages of the disease.

Elite Athletes will be relying on Astym therapy to help achieve their highest and best performance in Rio. Certified Astym providers will be on hand supporting their athletes.

Astym therapy has been proven highly effective and safe in treating tendinopathies and other soft tissue dysfunction. In addition, Astym therapy improves muscle performance, as shown in this randomized, controlled clinical trial.

Athletes’ Performance/EXOS, the premier facility that trains and conditions elite and professional athletes, has Astym therapy as a core component of its training and conditioning program. Brittani Cookinham, PT, DPT, ATC of EXOS is one of the Astym-certified clinicians that will be in Rio to support athletes, and she plans to rely heavily on Astym therapy to get her athletes in top condition. “Astym therapy isessential for athletes to perform at their highest level.”

Peer-reviewed research confirms that there is nothing like Astym® therapy. Here are some important points contained in peer-reviewed publications:

The Astym approach is the only regenerative medicine treatment in therapy

Astym therapy is highly effective and safe, and has broad applications

Proven to be more effective than other available treatments, Astym therapy has also been shown to be safe and effective across large populations.

Astym therapy demonstrates impressive results, even where other treatments fail

INTRODUCTION
An estimated 300,000 women are affected by breast cancer every year in the United States, and another 2.6 million are living posttreatment. As diagnostic technology has progressed and the understanding of the disease process has evolved, the number of mastectomies performed in the United States has increased. Breast reconstructive techniques have commensurately become more sophisticated along the same time- line. The result is that those facing mastectomy have the potential to simultaneously retain physical beauty and wholeness. Despite these advances, only 33% of women who are otherwise candidates for immediate reconstruction at the time of mastectomy choose reconstruction. The 2 reasons most attributed to this remarkable statistic are failure of the treatment team to refer the patient to a plastic surgeon at the time of diagnosis/decision for mastectomy and the resultant lack of understanding on the patient’s part regarding her reconstructive options.

It’s a stunning discovery that overturns decades of textbook teaching: researchers at the School of Medicine have determined that the brain is directly connected to the immune system by vessels previously thought not to exist. “I really did not believe there were structures in the body that we were not aware of. I thought the body was mapped,” said Jonathan Kipnis, a professor in the Department of Neuroscience and director of the University’s Center for Brain Immunology and Glia. How these vessels could have escaped detection when the lymphatic system has been so thoroughly mapped throughout the body is surprising on its own.

By BRIAN GILLIS | Published: APRIL 22, 2015

In the 1960s, NASA started sending astronauts into space. At first, people spent only a short period of time outside the earth’s gravitational pull.

However, after the International Space Station was introduced, astronauts started extending their stay. The zero gravity environment began causing weight loss, muscle atrophy, and decreased bone density. NASA was learning that exercising is hard when you can’t keep your feet on the ground!

To solve this problem, Dr. Robert Whalen, a NASA engineer, was tasked with developing a way for astronauts to exercise in space. He came up with a few options for NASA to consider, including a concept with a pressurized bubble that held astronauts down on a treadmill using air-pressure.

Just flip the pump!

All great ideas start in a garage!

While NASA decided to pursue one of Robert’s other ideas, his son Sean took a liking to his father’s concept of an air-pressure controlled treadmill. However, instead of adding gravity to run in space, he wanted to defy gravity to run on earth. By simply flipping the air pump, Sean created the concept for the Anti-Gravity Treadmill. While his father’s treadmill pulled the user onto the treadmill with a pressure-vacuum, Sean’s idea used air pressure to gently life the user off of the treadmill!

Sean and his father decided to make this idea a reality and went to work in their family’s garage in Palo Alto to develop the technology for what would become the AlterG Anti-Gravity Treadmill. After many months of trial and error, Sean created the first working prototype in 2005.

Time to bring in the professionals

Alberto Salazar was the first to adopt AlterG technology with his Olympic athletes

Before the first prototype was even finished, Alberto Salazar (an Olympic runner and coach of the best runners in the world) heard about the technology and wanted to help develop it for his athletes to use. He saw the ability to unweight a runner and reduce the impact of training as an invaluable tool for any competitive long distance runner.

Alberto Salazar began using the prototype with his athletes, including 10,000m Olympic silver medalist Galen Rupp (see picture). After Salazar and his athletes got on board, local Bay Area teams like the Oakland Raiders and Golden State Warriors started using the prototype in their training rooms.

AlterG becomes AlterG

In 2007, AlterG sold its first commercial unit to the Washington Wizards. Soon after, other NBA, NFL, and universities started defying gravity, too.

While today’s Anti-Gravity Treadmills look different than the prototype, the concept behind the magic remains the same. By creating a pressurized lifting force around the lower half of the body, the “differential air pressure” can be controlled to produce a variable lifting force for someone to walk, run, and exercise with reduced and adjustable impact.

Ladies and gentlemen, Don’t live with Urinary Incontinence. We are here to help.Call today for more information.

Given the increasing incidence of urinary incontinence in our aging population, greater attention is being paid to prevention. An easy preventive intervention would be learning proper technique of pelvic floor exercises or Kegels and performing them prior to the onset of urinary incontinence. Most patients currently perform Kegels incorrectly. All patients would benefit from confirmation of proper exercise technique by their physician or qualified pelvic floor physical therapist. Avoidance of chronic straining and maintaining a healthy weight also can reduce the risk of stress urinary incontinence.

In addition, patients with complaints of overactive bladder or urinary incontinence should be evaluated soon after the onset of the condition as patients with mild symptoms often have greater success with more conservative treatment options. Treatment of long-standing disease often involves more aggressive treatment with lower success rates.

The long-term effects of method of delivery, vaginal versus cesarean section, on urinary incontinence are currently controversial with conflicting data. It has been suggested that cesarean section protects the pelvic floor from long-term conditions including pelvic prolapse, urinary incontinence, and fecal incontinence but greater data needs to be analyzed prior to making clinical recommendations.